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New Blood Pressure Monitor For iPhone Costs 4 Times More Than Off-The-Shelf Version

One of the most interesting things I saw at this year’s Doctors 2.0 and You event was Withins’ Blood pressure monitor.

This iPhone-connected blood pressure monitor made its first appearance at CES, but you’ll finally be able to order one of your own today. Compatible with iPhone, iPad, and iPod touch, the $129 accessory costs three to four times as much as off-the-shelf blood pressure monitors, but integrates well if you’re looking to pair it with your Withings scale for a complete vitals management solution.

*This blog post was originally published at ScienceRoll*

No Data Is Better Than Bad Data: A Case Report Of Drug Misinformation

I have said that the best tool for treating atrial fibrillation (AF) is education. I still strongly believe this, perhaps more then ever.

AF presents itself to people in so many different ways–from no symptoms to incapacitation. Likewise, the treatments for AF range from simple reassurance and lifestyle changes, to taking a medicine, and on to having a complex ablation[s].

Because knowledge is so important to patients with AF, I encourage them to do outside research. This surely means going on-line. The problem, of course, comes with assessing the quality of information. It reminds me of what an old professor used to profess, “no data is better than bad data.”

What’s more, the vast diversity of AF makes comparing notes with friends problematic. One person’s wonder drug may be another’s poison.

Last week, this provocative AF headline came through on one of my Google Alert emails: 

“Flecainide Treatment Linked to Sudden Cardiac Death.” Read more »

*This blog post was originally published at Dr John M*

Omega-3 Fatty Acids: The Science Behind Their Potential Heart Health Benefits

The Biology of Omega-3 fatty acids: (Just a little science:)

When fish, flax-seeds or Brussels sprouts pass through the intestine, pancreatic enzymes transform the fat to free fatty acids. These acids are quickly taken up by the cells. Once in the cell, these fatty acids enter the mitochondria, endoplasmic reticulum and cytosol–places that you might recall because your mom helped you make a Cell sponge cake in 7th grade Biology.

In the cells, the Omega-3 fatty acids (ALA, DHA and EPA) exert their healthy influence in three major ways:

  • in the control of chemical messengers;
  • in the flux of ions—cell electricity;
  • in the smoothness and health of the cell membrane.

That’s enough about cells.

How do these (good) fats help our bodies?

Omega-3 fatty acids reduce Inflammation:

–Omega-3s get in the cellular (not phone) mix and end up competing with chemicals that cause inflammation—medical people say they antagonize bioactive mediators of inflammation.

–Newly-discovered by-products of Omega-3s are important in the resolution phase of inflammation. Biochem people call these chemicals, resolvins. All you have to remember here is this: to resolve (inflammation) is heart-healthy.

–When omega-3s are incorporated into the membranes of cells they do a lot of good: things like making the membrane more fluid and less sticky. For some reason, they even block genes that induce hardening of the arteries. (Genomic effects.)

Omega-3s benefit the heart: They… Read more »

*This blog post was originally published at Dr John M*

The New World View Of Coronary Artery Disease

In 2007, when the results were published from the COURAGE trial, all the experts agreed that this study would fundamentally change the way cardiologists managed patients with stable coronary artery disease (CAD).*

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*”Stable” CAD simply means that a patient with CAD is not suffering from one of the acute coronary syndromes – ACS, an acute heart attack or unstable angina. At any given time, the large majority of patients with CAD are in a stable condition.
____

But a new study tells us that hasn’t happened. The COURAGE trial has barely budged the way cardiologists treat patients with stable CAD.

Lots of people want to know why. As usual, DrRich is here to help.

The COURAGE trial compared the use of stents vs. drug therapy in patients with stable CAD. Over twenty-two hundred patients were randomized to receive either optimal drug therapy, or optimal drug therapy plus the insertion of stents. Patients were then followed for up to 7 years. Much to the surprise (and consternation) of the world’s cardiologists, there was no significant difference in the incidence of subsequent heart attack or death between the two groups. The addition of stents to optimal drug therapy made no difference in outcomes.

This, decidedly, was a result which was at variance with the Standard Operating Procedure of your average American cardiologist, whose scholarly analysis of the proper treatment of CAD has always distilled down to: “Blockage? Stent!”

But after spending some time trying unsuccessfully to explain away these results, even cardiologists finally had to admit that the COURAGE trial was legitimate, and that it was a game changer. (And to drive the point home, the results of COURAGE have since been reproduced in the BARI-2D trial.) Like it or not, drug therapy ought to be the default treatment for patients with stable CAD, and stents should be used only when drug therapy fails to adequately control symptoms.

When the COURAGE results were initially published they made a huge splash among not only cardiologists, but also the public in general. So cardiologists did not have the luxury of hiding behind (as doctors so often do when a study comes out the “wrong” way) the usual, relative obscurity of most clinical trials. Given the widespread publicity the study generated, it seemed inconceivable that the cardiology community could ignore these results and get away with it.

But a new study, published just last month in JAMA, reveals that ignore COURAGE they have. Read more »

*This blog post was originally published at The Covert Rationing Blog*

New SmartHeart Device Shares Home EKGs Via Smart Phones

SHL Telemedicine has announced the release of SmartHeart, a lightweight and portable device that they claim can take “hospital-grade” ECGs by “anyone, anywhere, anytime.” The device connects wirelessly to smartphones and can transmit the ECG to a physician for a preliminary diagnosis. The possibilities for a device like this are endless – but so are the questions it raises.

The device greatly streamlines the process of obtaining an ECG as it avoids the need to actually come in to a clinic and can be used to monitor high risk patients from their own homes. The smartphone can then transmit the ECG to an office or a hospital where health care professionals can examine them instantly. As cardiovascular disease is the leading cause of death in the US, a low-cost and easily used cardiovascular diagnostic device could have a huge impact on a sizeable part of the population. SmartHeart is set to cost $500, which is less than an iPhone itself.

However, a portable ECG device that anyone can supposedly use raises some major concerns. The first question is its practical application. For a patient to just have this at home implies that they are at high risk for cardiovascular events. Arrhythmias typically require continuous cardiac monitoring rather than a 10-second ECG, which this device does not appear to provide. So, is this device intended to Read more »

*This blog post was originally published at iMedicalApps*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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